706 research outputs found
Remission of severe restless legs syndrome and periodic limb movements in sleep after bilateral excision of multiple foot neuromas: a case report
<p>Abstract</p> <p>Introduction</p> <p>Restless legs syndrome is a sensorimotor neurological disorder characterized by an urge to move the legs in response to uncomfortable leg sensations. While asleep, 70 to 90 percent of patients with restless legs syndrome have periodic limb movements in sleep. Frequent periodic limb movements in sleep and related brain arousals as documented by polysomnography are associated with poorer quality of sleep and daytime fatigue. Restless legs syndrome in middle age is sometimes associated with neuropathic foot dysesthesias. The causes of restless legs syndrome and periodic limb movements in sleep are unknown, but the sensorimotor symptoms are hypothesized to originate in the central nervous system. We have previously determined that bilateral forefoot digital nerve impingement masses (neuromas) may be a cause of both neuropathic foot dysesthesias and the leg restlessness of restless legs syndrome. To the best of our knowledge, this case is the first report of bilateral foot neuromas as a cause of periodic limb movements in sleep.</p> <p>Case presentation</p> <p>A 42-year-old Caucasian woman with severe restless legs syndrome and periodic limb movements in sleep and bilateral neuropathic foot dysesthesias was diagnosed as having neuromas in the second, third, and fourth metatarsal head interspaces of both feet. The third interspace neuromas represented regrowth (or 'stump') neuromas that had developed since bilateral third interspace neuroma excision five years earlier. Because intensive conservative treatments including repeated neuroma injections and various restless legs syndrome medications had failed, radical surgery was recommended. All six neuromas were excised. Leg restlessness, foot dysesthesias and subjective sleep quality improved immediately. Assessment after 18 days showed an 84 to 100 percent reduction of visual analog scale scores for specific dysesthesias and marked reductions of pre-operative scores of the Pittsburgh sleep quality index, fatigue severity scale, and the international restless legs syndrome rating scale (36 to 4). Polysomnography six weeks post-operatively showed improved sleep efficiency, a marked increase in rapid eye movement sleep, and marked reductions in hourly rates of both periodic limb movements in sleep with arousal (135.3 to 3.3) and spontaneous arousals (17.3 to 0).</p> <p>Conclusion</p> <p>The immediate and near complete remission of symptoms, the histopathology of the excised tissues, and the marked improvement in polysomnographic parameters documented six weeks after surgery together indicate that this patient's severe restless legs syndrome and periodic limb movements in sleep was of peripheral nerve (foot neuroma) origin. Further study of foot neuromas as a source of periodic limb movements in sleep and as a cause of sleep dysfunction in patients with or without concomitant restless legs syndrome, is warranted.</p
The fluctuation energy balance in non-suspended fluid-mediated particle transport
Here we compare two extreme regimes of non-suspended fluid-mediated particle
transport, transport in light and heavy fluids ("saltation" and "bedload",
respectively), regarding their particle fluctuation energy balance. From direct
numerical simulations, we surprisingly find that the ratio between collisional
and fluid drag dissipation of fluctuation energy is significantly larger in
saltation than in bedload, even though the contribution of interparticle
collisions to transport of momentum and energy is much smaller in saltation due
to the low concentration of particles in the transport layer. We conclude that
the much higher frequency of high-energy particle-bed impacts ("splash") in
saltation is the cause for this counter-intuitive behavior. Moreover, from a
comparison of these simulations to Particle Tracking Velocimetry measurements
which we performed in a wind tunnel under steady transport of fine and coarse
sand, we find that turbulent fluctuations of the flow produce particle
fluctuation energy at an unexpectedly high rate in saltation even under
conditions for which the effects of turbulence are usually believed to be
small
Minimal size of a barchan dune
Barchans are dunes of high mobility which have a crescent shape and propagate
under conditions of unidirectional wind. However, sand dunes only appear above
a critical size, which scales with the saturation distance of the sand flux [P.
Hersen, S. Douady, and B. Andreotti, Phys. Rev. Lett. {\bf{89,}} 264301 (2002);
B. Andreotti, P. Claudin, and S. Douady, Eur. Phys. J. B {\bf{28,}} 321 (2002);
G. Sauermann, K. Kroy, and H. J. Herrmann, Phys. Rev. E {\bf{64,}} 31305
(2001)]. It has been suggested by P. Hersen, S. Douady, and B. Andreotti, Phys.
Rev. Lett. {\bf{89,}} 264301 (2002) that this flux fetch distance is itself
constant. Indeed, this could not explain the proto size of barchan dunes, which
often occur in coastal areas of high litoral drift, and the scale of dunes on
Mars. In the present work, we show from three dimensional calculations of sand
transport that the size and the shape of the minimal barchan dune depend on the
wind friction speed and the sand flux on the area between dunes in a field. Our
results explain the common appearance of barchans a few tens of centimeter high
which are observed along coasts. Furthermore, we find that the rate at which
grains enter saltation on Mars is one order of magnitude higher than on Earth,
and is relevant to correctly obtain the minimal dune size on Mars.Comment: 11 pages, 10 figure
Aeolian transport layer
We investigate the airborne transport of particles on a granular surface by
the saltation mechanism through numerical simulation of particle motion coupled
with turbulent flow. We determine the saturated flux and show that its
behavior is consistent with a classical empirical relation obtained from wind
tunnel measurements. Our results also allow to propose a new relation valid for
small fluxes, namely, , where and
are the shear and threshold velocities of the wind, respectively, and
the scaling exponent is . We obtain an expression for the
velocity profile of the wind distorted by the particle motion and present a
dynamical scaling relation. We also find a novel expression for the dependence
of the height of the saltation layer as function of the wind velocity.Comment: 4 pages, 4 figure
Corridors of barchan dunes: stability and size selection
Barchans are crescentic dunes propagating on a solid ground. They form dune
fields in the shape of elongated corridors in which the size and spacing
between dunes are rather well selected. We show that even very realistic models
for solitary dunes do not reproduce these corridors. Instead, two instabilities
take place. First, barchans receive a sand flux at their back proportional to
their width while the sand escapes only from their horns. Large dunes
proportionally capture more than they loose sand, while the situation is
reversed for small ones: therefore, solitary dunes cannot remain in a steady
state. Second, the propagation speed of dunes decreases with the size of the
dune: this leads -- through the collision process -- to a coarsening of barchan
fields. We show that these phenomena are not specific to the model, but result
from general and robust mechanisms. The length scales needed for these
instabilities to develop are derived and discussed. They turn out to be much
smaller than the dune field length. As a conclusion, there should exist further
- yet unknown - mechanisms regulating and selecting the size of dunes.Comment: 13 pages, 13 figures. New version resubmitted to Phys. Rev. E.
Pictures of better quality available on reques
URBAN TERRAIN CLIMATOLOGY AND REMOTE SENSING *
. Urban areas have been conceived of as monolithic heat islands because traditional ground observation techniques do not lend themselves to more specific analyses. Observations of urban energy-exchange obtained from calibrated electro-optical scanners combined with energy budget simulation techniques provide tools to relate the urban land use mosaic to the heat island phenomenon. Maps of surface energy-related phenomena were made from airborne scanner outputs for selected flightpaths across the city of Baltimore, Maryland. Conditions for the flight time were simulated according to the various types of land use using an energy budget simulation model which lends itself to extrapolation of simulated grid-point conditions into a map form. Maps made by simulation compare sufficiently well with those made by aerial observation to encourage further refinement of the simulation approach.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72392/1/j.1467-8306.1976.tb01110.x.pd
Numerical simulation of turbulent sediment transport, from bed load to saltation
Sediment transport is studied as a function of the grain to fluid density
ratio using two phase numerical sim- ulations based on a discrete element
method (DEM) for particles coupled to a continuum Reynolds averaged description
of hydrodynamics. At a density ratio close to unity (typically under water),
vertical velocities are so small that sediment transport occurs in a thin layer
at the surface of the static bed, and is called bed load. Steady, or
'saturated' transport is reached when the fluid borne shear stress at the
interface between the mobile grains and the static grains is reduced to its
threshold value. The number of grains transported per unit surface is therefore
limited by the flux of horizontal momentum towards the surface. However, the
fluid velocity in the transport layer remains almost undisturbed so that the
mean grain velocity scales with the shear velocity u\ast. At large density
ratio (typically in air), the vertical velocities are large enough to make the
transport layer wide and dilute. Sediment transport is then called saltation.
In this case, particles are able to eject others when they collide with the
granular bed, a process called splash. The number of grains transported per
unit surface is selected by the balance between erosion and deposition and
saturation is reached when one grain is statistically replaced by exactly one
grain after a collision, which has the consequence that the mean grain velocity
remains independent of u\ast. The influence of the density ratio is
systematically studied to reveal the transition between these two transport
regimes. Based on the mechanisms identified in the steady case, we discuss the
transient of saturation of sediment transport and in particular the saturation
time and length. Finally, we investigate the exchange of particles between the
mobile and static phases and we determine the exchange time of particles.Comment: 17 pages, 14 figures, submitted to Physics of Fluid
Long-Horizon Consumption Risk and the Cross-Section of Returns: New Tests and International Evidence
Nck adapter proteins: functional versatility in T cells
Nck is a ubiquitously expressed adapter protein that is almost exclusively built of one SH2 domain and three SH3 domains. The two isoproteins of Nck are functionally redundant in many aspects and differ in only few amino acids that are mostly located in the linker regions between the interaction modules. Nck proteins connect receptor and non-receptor tyrosine kinases to the machinery of actin reorganisation. Thereby, Nck regulates activation-dependent processes during cell polarisation and migration and plays a crucial role in the signal transduction of a variety of receptors including for instance PDGF-, HGF-, VEGF- and Ephrin receptors. In most cases, the SH2 domain mediates binding to the phosphorylated receptor or associated phosphoproteins, while SH3 domain interactions lead to the formation of larger protein complexes. In T lymphocytes, Nck plays a pivotal role in the T cell receptor (TCR)-induced reorganisation of the actin cytoskeleton and the formation of the immunological synapse. However, in this context, two different mechanisms and adapter complexes are discussed. In the first scenario, dependent on an activation-induced conformational change in the CD3Ξ΅ subunits, a direct binding of Nck to components of the TCR/CD3 complex was shown. In the second scenario, Nck is recruited to the TCR complex via phosphorylated Slp76, another central constituent of the membrane proximal activation complex. Over the past years, a large number of putative Nck interactors have been identified in different cellular systems that point to diverse additional functions of the adapter protein, e.g. in the control of gene expression and proliferation
- β¦